Postoperative serum amyloid A as a primary marker in a predictive model for ventilator-associated pneumonia in elderly patients with acute ischaemic stroke undergoing endovascular therapy with general anaesthesia.
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引用次数: 0
Abstract
Background: The risk factors associated with ventilator-associated pneumonia (VAP) in acute ischaemic stroke (AIS) patients who have undergone endovascular therapy have been primarily reported as clinical-related parameters.
Aim: This study aims to combine clinical parameters with inflammatory biomarkers to identify VAP-related risk factors and develop a predictive model.
Methods: A total of 564 AIS patients were recruited and divided into the training set (n = 395) and the validation set (n = 169). The least absolute shrinkage and selection operator (LASSO), univariate and multivariate logistic regression analyses were utilized to examine the independent risk factors or biomarkers associated with VAP.
Findings: We identified four VAP-associated risk factors or biomarker in AIS patients, consisting of thrombolysis in cerebral infarction (TICI) score (0-IIa) (OR = 4.528; 95% CI: 2.249-9.119; P < 0.001), admission national Institute of Health stroke scale (NIHSS) (OR=1.330; 95% CI: 1.217-1.453; P<0.001), neutrophil lymphocyte ratio (NLR) (OR=2.179; 95% CI: 1.312-3.618; P=0.003), and postoperative serum amyloid A (SAA) (OR=1.194; 95% CI: 1.146-1.244; P<0.001). This predictive model demonstrated robust performance and stability, with an AUC of 0.926 (95% CI: 0.899-0.953) in the training set and 0.937 (95% CI: 0.897-0.977) in the validation set. Notably, using the machine learning algorithm Random Forest for feature importance ranking, postoperative SAA emerged as the most critical predictor of VAP.
Conclusion: The predictive model has good predictive value for VAP. Postoperative SAA may serve as a rapid diagnostic biomarker for predicting VAP.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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